1974, 02-13 Permit App: K3625 Residence• 0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, CIOUOR1 OUSE, SPOKANE, WASHINGTON 99401
APPLICATION FOR LAND USE OR STRUCTURE PERMIT/ -1
GENERAL REQUIREMENTS PERMIT FEE --- -------------------
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
kind or alter any building or structure already erected, or to change a land use. Construction must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
Highway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE c� a 7 iel
Name of
Own d �Gvzt —Address 6--y Z �_� - — Phone'
Architect Phone Eagineer Phone
Contractor Address Phone
Legal Description of Proper ty,(,G vecomplete descript * from deed, tax receipt` etc.) IV t
1-1
DESCRIPTION OF WORK: New Addition Remodel Moving Bld . Zone Fire Zone
Size of Lot J0 V J,0 Sewage System Sto 'es
Const Dimensions -z Total Sq. Ft. Valuation`s ic
(Fr e, concrete, brick, etc.)
R 4- Baths ..2_ Basemen Foundation Const. ��yc L�-t-�C r� _ Chimney --- Fireplace d-;2-
17
Z1 (Full, part one)(Kind) Number)
Heat. Syste Type of Roofing t. Finish u ,O � t. Wall Finish
Use of Bldg. j
Garage or Carport Attached
No. of Units Bedro s
Private Detatched
L" PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage Sys-
tem and water supply lines.
NORTH State License No.
Ind. Ins. Acct. No.
/ _ / ` /-F_
REQUIRED
Plumbing Permit >
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby c tify infor ion submitted is correct and there are no other structures located on th' property except
as show .
Owner or Agent Date
A LAND US OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be - e zone is C
Sewage Permit Number Issued Building Permit Receipt Issued
Remarks I
Form 523 Bldg. Code